A Case of Pulmonary Langerhans Cell Histiocytosis with Secondary Pneumothorax

Abstract

A 36-year-old male cigarette smoker complained of chest pain and dyspnea and developed a left pneumothorax. Chest CT scan revealed a left pneumothorax, bilateral diffuse reticulonodular opacities, and a polycystic lesion. To make a definitive diagnosis, a lung biopsy followed by Talc poundrage for pleurodesis were performed under video-assisted thoracoscopic surgery. The biopsied specimen revealed the presence of S-100 protein and CD4-positive Langerhans cells in the broncho-bronchiolocentric nodular lesions. Therefore, pulmonary Langerhans cell histiocytosis (PLCH) was diagnosed. The post operative course was good, and the pneumothorax was cured immediately. The patient was instructed to stop smoking. There has been no recurrence of a pneumothorax during 6 months of observation. When a patient presents with secondary pneumothorax and a polycystic lesion, PLCH has to be considered in the differential diagnosis.